Poison Exposure Research Articles

Unintentional Acute Poisoning Related Emergency Department Visits in Children in a Single-Center: A Nine-Year Prospective Survey.

Pediatric morbidity due to unintentional poison exposure is a significant burden on public health. We prospectively characterize patterns of unintentional poison exposure in a single pediatric emergency department, using a detailed computerized questionnaire for all unintentional injuries admitted during 2009 to 2017. Out of 71,765 visits due to unintentional injuries, 252 children were admitted due to unintentional poison exposure. Most (198/252, 79%) were between 1 and 3 years of age. The majority of events (209/252, 82.9%) occurred at the patient's home and 81% (205/255) were classified as exploratory ingestion. In 41/252 (14%) cases, exposure to more than one substance was reported. Most events 231/293 (79%) involved medications and 21% were due to domestic products. Four medications account for 45% of the events (Paracetamol, Salbutamol, Antihypertensive, and Antidepressants). Opioids were responsible for only 1.7%. By, collaboration between government, public health, educational institutions and commercial companies, can the burden of pediatric unintentional poison exposure be reduced.

Poisoning during the COVID-19 pandemic and lockdown: retrospective analysis of exposures reported to the Poison Unit of the Mansoura Emergency Hospital

Introduction Coronavirus disease 2019 (COVID-19), originated in late December 2019, in Wuhan, China. The World Health Organization declared a pandemic on 11 March 2020, with the rapidly rising number of cases and fatalities over hours and days all around the world. Aim To assess the number and the trend of the poisoning consultations to the Poison Unit in the Mansoura Emergency Hospital during the era of the COVID-19 pandemic in 2020. Methods We collected data from the database of the Poison Unit and the Statistics Department of the Mansoura Emergency Hospital of the cases and the calls coming to the Poison Unit in the period from January 2018 through December 2020. We compared 2020 exposures to 2018–2019 exposures by using simple logistic models to provide effect size with odds ratios. Results The Mansoura Emergency Hospital Poison Unit treated 1752 cases in 2020, compared to 2210 cases in 2018 and 2539 cases in 2019. The Poison Unit treated 26% fewer patients in 2020 than either 2018 or 2019), while calls increased nearly 50% in 2020 than in 2018 and 2019. Calls came more frequently from the general public than health professionals and more frequently in afternoon and evening than in the morning. There was a significant increase in the cases of pharmaceuticals ingestion, food poisoning, corrosives and households exposures in 2020 compared to 2018 and 2019 (p-value 0.004, 0.024, and 0.0002, respectively; odds ratio 1.224, 1.691, and 1.692, respectively). Conclusion The COVID-19 pandemic changed the pattern of poisoning exposure and use of the Poison Control Center services.

A retrospective review of calls to the Poisons Information Helpline of the Western Cape during the first 6 months of the COVID-19 pandemic in South Africa.

BackgroundSince the start of the coronavirus disease 2019 (COVID-19) pandemic, poison centres worldwide have reported an increase in exposures to chemicals used for infection prevention. Increased availability and use could lead to an increase in exposures. Potential effects on a South African Poison Information Helpline were unknown, therefore a study was performed to describe changes in call volume and profile of poison exposures.MethodsA retrospective analysis was conducted on an observational database of telephone enquiries. All human-related poisoning exposure call data collected from 01 March to 31 August during 2018, 2019 and 2020 were extracted and analysed. Summary statistics were used to describe all variables.ResultsThe total number of calls were 5137, 5508, and 5181 in 2018, 2019, 2020, respectively. The monthly call number during 2020 was mostly less than in 2019. More calls were received from the public calls (39.4% vs 33.1%) and for accidental exposures (65.6% vs 62.3%) increased during 2020 compared to 2019. Exposures to pharmaceuticals decreased by 14.8% from 2019 to 2020, while exposures to eucalyptus oil more than doubled from 21 in 2019 to 43 during 2020. Exposures to antiseptics and disinfectants increased by 60.4%, mainly due to hand sanitisers exposure which showed a 26-fold increase from 2019 (n = 6) to 2020 (n = 156).ConclusionA change in the profile of poison exposures was observed during the COVID-19 pandemic. Lockdown regulations and greater availability of antiseptics and disinfectants probably led to the increase in exposures. Although symptoms were mostly mild, the public should be educated on safe storage and proper use of all chemicals.

Benzene exposure and risk of benzene poisoning in Chinese workers

ObjectivesBenzene is a known haematoxin and leukemogen that can cause benzene poisoning (BP), that is, a persistent reduction in white cell counts that is strongly associated with increased risk of...

Animais peçonhentos em Pernambuco: crianças em risco

Abstract Objectives: to analyze the epidemiological and clinical aspects of accidents caused by venomous animals in children under 15 years old. Methods: a cross-sectional study with an analytical component using secondary data from Centro de Informação e Assistência Toxicológica de Pernambuco (CIATox-PE), (Poison Center in Pernambuco)), in 2017 to 2019. Notifications of accidents caused were included in the studied age group and evaluated the characteristics of poisoning (animal classification, exposure zone, place and time of the occurrence and specific use of serum therapy), and of the patient (sociodemographic variables, clinical condition and evolution). The analysis performed in STATA® 13.1 presents frequency distribution tables and Pearson’s chi-square for comparison. Results: of the 2678 notifications, 82,8% were scorpionism and 10, 8% snakebite. The age group of1 to 9 years old (70.5%) and being male (54.1%) were predominant. Most of the cases occurred in urban area (80.9%), in Recife (67.3%), inside the victim’s residence (83.9%) and at night (47.3%). The majority (87.1%) were classified as ‘mild severity’, 10% received antivenom therapy and one died (by scorpionism). Two cases of snakebite in the workplace were registered. Conclusion: there was a high frequency of accidents caused in the urban area, which may be related to the lack of urban planning and sanitary education. The accidents caused among children in the household environment and the suspicion of child labor in the age group of 10 to 14 years old were also highlighted which favors the development and habits of the venomous animal.

2020 webPOISONCONTROL data summary

IntroductionIncreasing use of the internet for health information has decreased utilization of traditional telephone-based poison centers in the United States. webPOISONCONTROL®, a browser-based tool and app was launched to meet the growing demand for online, personalized recommendations for human poison exposures. This study was conducted to characterize webPOISONCONTROL cases and highlight its potential for real-time monitoring of poisoning. MethodsCase data for all completed, nonduplicated public cases entered in 2020 were analyzed using a custom Qlik Sense dashboard. ResultsOf the 156,202 cases, 52.9% occurred in children younger than 4 years. Most cases (109,057, 69.8%) were initially triaged to home, 28.4% were advised to call Poison Control, and 1.7% were referred to the ED. Follow-up was available for 33.3% of home-triaged cases; 1.7% of those had a change in triage recommendation.Pharmaceuticals were implicated in 41.5% of cases (nonpharmaceuticals in 58.5%). Ingestion was the most common route (88.4%, 138,012). One-time double dose therapeutic error cases were implicated in 17,901 cases (27.6% of pharmaceutical cases). Cosmetics (13.9%) and cleaning substances (12.9%) were the most frequent substance categories. Melatonin was the most frequently implicated generic substance (4.5% of cases). Most (72.0%) cases had no effect (21.4%), a minor effect (3.9%) or were minimally toxic with unknown outcome (46.7%). There were no deaths, 17 major outcomes (0.01%), and 26.7% of cases had potentially toxic exposures with no outcome determination.In 2020, webPOISONCONTROL handled 7.3% as many human poison exposure cases as were reported to U.S. phone-based poison centers. Online cases are skewed towards younger ages (53% in children younger than 4 years vs 37% of phone-based cases) and towards nonpharmaceuticals (58.5% vs 43.5%). Near real-time data visualizations enabled detection of COVID-19-related increases in exposures to hand sanitizers and cleaners, illustrating the public health surveillance and hazard detection capabilities of webPOISONCONTROL. ConclusionThe webPOISONCONTROL tool provides a safe, quick and fully-automated alternative to those who are unable or unwilling to use the telephone to call a traditional poison center.

Waste toner-derived micro-materials as low-cost magnetic solid-phase extraction adsorbent for the analysis of trace Pb in environmental and biological samples.

Lead (Pb) is a toxic heavy metal and is commonly used in industrial applications. Thus, Pb poisoning is a concerning public health issue worldwide. The amounts of lead in natural water, urine, and blood can serve as significant indicators for monitoring the exposure of Pb poisoning. Waste toner has the characteristics of both "waste" and "resource," as it is a "resource in the wrong place." Here, a low-cost carboxylate-functionalized magnetic adsorbent was first synthesized from waste toner by a simple thermal treatment and served as a novel adsorbent with a flexible multidentate O-donor for pre-concentration of trace Pb. The characterization, adsorption behavior, and various factors of adsorption and desorption were adequately optimized, and prior to graphite furnace atomic absorption spectrometry (GFAAS) detection, a new magnetic solid-phase extraction method was proposed for the analysis of Pb in real environmental water and biological samples. The developed method exhibited a low detection limit (0.003μgL-1), high enrichment factor (88.6-fold), good linearity (0.01-0.3μgL-1), satisfactory precision with relative standard deviations of 7.9% (n = 7, CPb = 0.02μgL-1), fast adsorption kinetics (5min), and strong ability to overcome matrix interference. Validation was also performed by analyzing a certified standard reference material, and the method was successfully applied to real tap water, lake water, human urine, and human blood serum with satisfactory recoveries of 92.6-109%.

Diagnostic Approach Common Cases of Vitamins Toxicity in Children

Pediatric emergency departments have recorded visits by afraid parents who are worried that their child has been poisoned. Often, attendances of poisoning cases at emergency room after poison exposure is unnecessary, but sometimes for lifesaving. In young children especially among toddlers aged between one- and three-years poisoning is common accidentally while they explore their environment as part of their normal natural development, or deliberately in response to stress or underlying mental problems .Young children are at a high risk of accidental poisoning when they try to discover the world around them by playing with things – opening the cabinets, mother’s handbag , imitating their parents or adult in actions especially if there is an elderly at home has one of geriatric diseases such as hypertension, diabetes mullites …and taking medication contiguously so an accidental poisoning occurs as a trial from child to learn who ingest that. The child is detected by parents or caregiver by chance while playing with a packet of tablets or with some of them in mouth. Deliberately poisoning usually happens in adolescent as attempting self-harm or suicide purpose by ingested large quantities of tablets than young children. Poisoning may be presents because of error doses which is prescribed by health professionals by wrong.

Trends in Childhood Poison Exposures and Fatalities: A Retrospective Secondary Data Analysis of the 2009-2019 U.S. National Poison Data System Annual Reports.

Despite significant prevention efforts, childhood poison exposures remain a serious public health challenge in the United States. This study aimed to assess annual trends of pharmaceutical vs. non-pharmaceutical poison exposures in the US among children 0–19 years and compare the odds of death by children’s age group. Poison exposure and fatality data were retrospectively extracted from 2009 to 2019 National Poison Data System (NPDS) annual reports for children in all reported age groups. Overall, there was a significant reduction in the annual population-adjusted poison exposures in children (annual percentage change = −2.54%, 95% CI = −3.94% to −1.15%, p < 0.01), but not in poisoning-related fatalities. Children 0–5 had similar odds of dying from exposure to non-pharmaceuticals vs. pharmaceuticals. The odds of children 6–12 dying from non-pharmaceuticals vs. pharmaceuticals was 2.38 (95% CI = 1.58, 3.58), χ2 = 18.53, p < 0.001. In contrast, the odds of children 13–19 dying from pharmaceuticals vs. non-pharmaceuticals was 3.04 (95% CI = 2.51, 3.69), χ2 = 141.16, p < 0.001. Suicidal intent accounted for 40.63% of pharmaceutical deaths in children 6–12, as well as 48.66% of pharmaceutical and 31.15% of non-pharmaceutical deaths in children 13–19. While a significant decline in overall childhood poison exposures was reported, a decrease in poisoning-related fatalities was not observed. Children in different age groups had contrasting relative odds of death from pharmaceutical and non-pharmaceutical exposures. Among older children, a greater proportion of poisoning-related deaths was due to intentional suicide. These findings provide evidence of age-specific trends in childhood poison exposure risk and directions for future poison prevention efforts and behavioral health partnerships.

Biological functions of cobalt and its toxicology and detection in anti-doping control

Objectives. Over the last decade, hematopoietic stimulants have grown increasingly popular in elite sports. This is supported by the growing number of high-profile doping scandals linked to their use. A group of these stimulants includes cobalt salts, which cause an increase in the oxygen capacity of the blood as well as a powerful stimulation of metabolic processes, resulting innoticeable competitive advantages. The use of cobalt salts is regulated according to the Prohibited List of the World Anti-Doping Agency (WADA). Currently, only a few works have been dedicated to solving the problem of detecting the abuse of cobalt salts in anti-doping control. Only a few laboratories have included cobalt salt determination in their methodological bases. The purpose of this review is to attract the attention of the scientific community to the toxicity of cobalt compounds, consequences of their intake, and pharmacokinetics, as well as the problems in their detection methods due to their widespread availability in the modern market and the growing number of abuse cases.Results. The main biological functions of cobalt, cellular levels of exposure, toxicity, and symptoms of cobalt salt poisoning are presented in detail in this review article. The data from the literature on the main methods for detecting cobalt as a doping agent have been generalized and systematized. There is a major focus on the amount of cobalt in dietary supplements that could cause an athlete to test positive for cobalt when they are consumed.Conclusions. After analyzing promising cobalt detection approaches and methods, it was determined that high-performance liquid chromatography in combination with inductively coupled plasma mass spectrometry has an undeniable advantage for detecting cobalt as a doping agent. The lack of explicit WADA requirements for detection methods and the lack of its obligation to determine cobalt make it tempting for unscrupulous athletes to use its salts. Therefore, antidoping laboratories must implement the abovementioned method as soon as possible.

Exposures in pregnant patients reported to United States Poison Centers

Background Limited data describe poisoning exposures in pregnant women. Previous studies are limited to inpatient populations, those seen only by toxicologists, or single poison centers. This study aimed to describe poison exposures reported to U.S. poison control centers in pregnant patients compared to non-pregnant controls. Methods This was a retrospective observational study of exposures reported to the American Association of Poison Control Centers National Poison Data System from 2000 through 2019. Pregnant patients were included from 15–44 years along with a random sampling of 5:1 age and year matched control group of non-pregnant exposures. Demographics, primary substance, and known medical outcomes were described. Chi square analysis was performed for comparisons. Results From 2000 to 2019, a total of 131,619 pregnant cases and 658,095 non-pregnant controls were identified. The median age was 27 years (IQR: 22, 31) for the matched groups. For known trimester of pregnancy: 29.8, 37.0, and 28.2% were in the first, second, and third trimester, respectively. Most common exposures were analgesics and cleaning products. Intentional exposures were more common in non-pregnant compared to pregnant cases (41.2 vs 21.9%; OR 2.71, 95% CI 2.67–2.75), mostly self-harm attempts (31.5 vs. 15.8%). Notably, there was a large discrepancy in the proportion of environmental exposures, with fewer in non-pregnant controls compared with pregnant cases (3.8 vs. 12.1%; OR 0.29, 95% CI 0.28–0.29). More non-pregnant cases had multiple substance exposures compared with pregnant cases (22.2 vs. 10.9%; OR 2.34, 95% CI 2.29–2.38). There were more moderate effect outcomes in non-pregnant compared with pregnant cases (13.2 vs. 6.3%; OR 2.25, 95% CI 2.20–2.30). Conclusions Outcomes of poisoning exposures in pregnant patients reported to U.S. poison centers are less serious compared to non-pregnant controls, likely due to the lower rates of intentional abuse and self-harm exposures and greater number of minimally toxic environmental exposures.

DUSHI VISHA W.R.T. MODERN SLOW-ACTING POISON AND THEIR SKIN MANIFESTATION

According to Ayurveda, prevention of disease and maintenance of health are more important than the treatment of disease. As given in Ayurvedic Samhitas, a poison is a substance that vitiates the normal functioning of dosha, dhatu, mala. Thousands of harmful toxins are present in our atmosphere (Air, water and earth) that are ingested by human beings on daily basis. As described in our Ayurvedic Samhitas, Dushi Visha is an intake of toxic drugs which is less potent (Denatured) and remains in a dormant state within the body for years together without causing any major harm to the body. As we see in today's era workers working in the lead industry like enamel workers, glass blowers, printing works have typical chronic lead poisoning symptoms such as constipation, tremors, menstrual disarrangements etc. Due to chronic exposure to lead which accumulates in the body and produces its ill effect like Dushi Visha. Arsenic, copper, mercury chronic occupational poisoning also happened due to long exposure of poi- son working in the respective industry. In agriculture, chronic exposure to OPP, OCP, weed killers like parquet, chlorophenoxy acetates, chlorates used to prevent infection in plants, being sprayed by farmers on daily basis, leads to symptoms like dysphasia, oropharyngeal ulcers, coughing, pain in the abdomen, etc. These symptoms resemble Dushi Visha like symptoms. From this article, we may correlate the symptoms of Dushi Visha with the dermatolog- ical manifestation of chronic occupational poisoning and agricultural field exposure to weed killers, which may behelpful to understand the concept of Dushi Visha. We need to realize the health hazardous effects of cumulative poison and its proper time to time prevention as well as its proper treatment. Keywords: Dushi Visha, Skin manifestation, Slow acting poison

A study about clinic-epidemiological pattern of acute poisoning in pediatric age group

Background: Poisoning is one of the most common causes for emergency hospitalization and mortality in children. Mostly it is accidental in nature and can be prevented by awareness in caregivers. Recently due to increased use of many new chemicals in homes and agriculture clinic etiological profile of poisoning is also changed.&#x0D; Aims and Objectives: To study clinic-epidemiological pattern of acute poisoning in hospitalized children and To evaluate association of clinicodemographic factors to age of intoxicated children to evaluate association of clinicodemographic factors to age of intoxicated children.&#x0D; Material and Methods: A cross sectional study was conducted from October 2019 to February 2020 in pediatric department of a tertiary care center. Child admitted with alleged history of poisoning included in study. Type and amount of poison, clinical presentation, outcome and demographic profile were recorded from medical records of patients.&#x0D; Results: Study was conducted among 50 patients of poisoning. 74% patients were under 5 year of age while 56% were boys and 44% were girls. Patients admitted due to ingestion of Insecticides and pesticides (18%), hydrocarbons (14%), medicines (12%) and agricultural products (8%), plant products ((16%) and others. Maximum number of patients intoxicated with household products (56%). Age was significantly associated with residence (p = 0.02) and place of exposure (p = 0.01) and nature of poisoning (p = 0.05).&#x0D; Conclusion: In children below 5 year of age incidences of poisoning are more frequent, most of the cases are accidental in nature and easily preventable. Proper care in this tender age is very important in order to prevent morbidity and mortality due to poisoning.

Systematic Review of Human Poisoning and Toxic Exposures in Myanmar.

The International Health Regulations (2005) promote national capacity in core institutions so that countries can better detect, respond to and recover from public health emergencies. In accordance with the ‘all hazards’ approach to public health risk, this systematic review examines poisoning and toxic exposures in Myanmar. A systematic literature search was undertaken to find articles pertaining to poisoning in Myanmar published between 1998 and 2020. A number of poisoning risks are identified in this review, including snakebites, heavy metals, drugs of abuse, agrochemicals and traditional medicine. Patterns of poisoning presented in the literature diverge from poisoning priorities reported in other lower-middle income countries in the region. The experience of professionals working in a Yangon-based poison treatment unit also indicate that frequently observed poisoning as a result of pharmaceuticals, methanol, and petroleum products was absent from the literature. Other notable gaps in the available research include assessments of the public health burden of poisoning through self-harm, household exposures to chemicals, paediatric risk and women’s occupational risk of poisoning. There is a limited amount of research available on poisoning outcomes and routes of exposure in Myanmar. Further investigation and research are warranted to provide a more complete assessment of poisoning risk and incidence.

Evaluation of Severity of Poisoning Exposures among Patients Presented to Poison Control Center, Ain Shams University Hospitals, Egypt during 2019

Background: Poisoning exposure continues to be an important public health concern in many developing countries and a major cause of morbidity and mortality in Egypt. The information released by the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH) is mostly a trigger for increasing hazards challenging the community. Aim: To evaluate severity of poisoning exposures among patients presented to PCC-ASUH during year 2019. Methods: A retrospective study involved patients presented to the PCC-ASUH with history of poisoning during 2019. Results: This study included 21,492 patients. The majority of poisoning incidents were at the age group of 15 – 25 years (34%) and females outnumbered males (54.8% versus 45.2%). Route of poisoning was mostly oral (89.1%). Most poison exposures were suicidal (51.5%). Drug poisoning constituted the majority of cases (59.5%). Centrally acting drugs were the commonest drugs (18%) and household chemicals were the commonly used poisons (13.4%). Poisoning severity score was mild in 79.4% of cases, moderate in 14.4% and severe in 6.2% of cases. Mortality rate was 0.66%. Higher PSS was associated with prolonged hospital stay and death. Conclusion: Poisoning is more common in young and middle-aged people. Ingestion was the main route of poisoning and suicidal poisoning predominated. Corrosives and detergents were the most commonly involved toxic substances while centrally acting drugs topped the list of drug poisoning. Higher PSS was associated with prolonged hospital stay and death. Recommendations: Poisoning severity score is a simple tool for better poisoning assessment. Strict regulations are needed to control medication marketing.

Medical toxicology experience: Poisoning consultations cases registry in Saudi Ministry of Health -2020 annual report.

Saudi poison control centers provide surveillance data that should be used to determine the magnitude of poisoning exposures and the level of public awareness that is to evaluate control measures. This work aimed to review and assess the characteristics of toxic events received by toxicological information center's hotline all over Saudi Arabia during 2020. Data were collected from the poison control centers in Saudi Arabia. Cases of poisonings were studied during the period from 1st January to 31st December 2020. The poison control center received 20,513 calls in the year 2020. Most of calls were from Riyadh city (40.9 %) and from public places (92.9 %). Regarding the patients, most of the cases were less than 6 years old and more than half of them were males. The majority of toxic exposures were accidental oral poisoning. About 84 % of patients (84.3 %) called for help within one hour from poisons exposure. Household substances toxic exposure represented about one third of toxic cases. Chemicals and alcohol sanitizers' poisoning were the highest among house hold substances toxicities (39.3 % and 17.7 % respectively of all household substances toxicity). In addition, the most frequently ingested drugs were vitamins poisoning. Household chemicals represented the highest risk in exposures among children below 6 years. Finally, we recommended widespread awareness of the poisons risk and the importance of poison control that play a great role in time management and saving lives.

Pediatric Ingestions: New High-Risk Household Hazards.

1. David C. Sheridan, MD, MCR* 2. Adrienne Hughes, MD*,† 3. B. Zane Horowitz, MD*,† 1. *Department of Emergency Medicine, Oregon Health & Science University, Portland, OR 2. †Oregon Poison Center, Portland, OR 1. Most poisoning events in preschool-aged children continue to be accidental ingestions in the home, ranging from medications to toys and common household products. 2. Knowledge of these common ingestions is important to properly diagnose, treat, and refer to emergent care as needed. 3. Pediatricians and emergency physicians should be familiar with new exposures and treatment options that have been recommended for some novel agents. After completing this article, readers should be able to: 1. Explain the general epidemiology and emerging trends for pediatric poisonings and exposures. 2. Become familiar with several new products that have emerged as high-risk exposures in preschool-age children. 3. Describe the potential serious clinical complications and treatment options for these new high-risk agents. There is good news and bad news when it comes to pediatric poisoning and exposures. The last full year that the American Association of Poison Control Centers reported data was 2017. (1) There were 2,115,186 human exposures called in to poison centers in the 50 states and US territories, of which children represented the largest percentages. Children younger than 6 years were the concern in 45% of calls, those 6 to 12 years of age represented 6% of calls, and adolescents 13 to 19 years of age 8% of calls. (1) Although no death of a child is considered a positive outcome, the trend in fatalities from poison exposure for toddlers has been decreasing. The good news is that of 956,871 calls to poison centers regarding preschool-age children (<6 years old), there were only 19 fatal outcomes. The bad news is that the data identify room for improvement in adolescent poison prevention. In adolescents, ages 13 to …

Road-crossings, vegetative cover, land use and poisons interact to influence corridor effectiveness

Landscape connectivity is essential to conserving resilient wildlife populations in the Anthropocene. Maintaining connectivity requires preserving or restoring patches of habitat, accounting for the behavioral factors that determine movement between patches and mitigating threats. We measured natural and anthropogenic features that influence movement and mortality for bobcats (Lynx rufus) in a system threatened with complete isolation by urbanization. Our overarching objective was to inform local land acquisition and restoration to maintain two last-chance wildlife corridors. We collected five-minute movement data from 36 bobcats in central California to assess features of road-crossing hotspots and model habitat selection, including functional responses to housing densities and vegetation. We collected opportunistic mortalities and assessed rat poison exposure to evaluate edge effects as acute threats. Bobcats strongly selected for natural vegetation, evident at the level of a single tree or shrub. Individuals selected low-density housing (<5 houses/ha) yet avoided high-density housing development and monoculture agriculture. Narrow (<25 m wide) riparian strips were critical to connectivity. Bobcats successfully crossed the busiest highway in the landscape but frequently died when crossing a less-trafficked road with a high median barrier. Vehicles and disease were dominant sources of mortality, while 94% of bobcats were exposed to rat poisons despite California's 2014 regulations implemented to reduced wildlife exposure. Maintaining landscape connectivity requires conserving key habitats, mitigating the effects of infrastructure, and sustaining populations of highly mobile, healthy individuals. Our findings have driven conservation action through land acquisition. We demonstrate how robust, rapid data collection can facilitate real-world conservation outcomes.

Poisoning Exposures in People with Dementia (2014‒2019): A Retrospective Study

ObjectiveTo describe the most common types of poisoning exposures, implicated substances and underlying sources of medication error in people with dementia. DesignRetrospective analysis of call records from the New South Wales (NSW) Poisons Information Center (PIC). Setting and ParticipantsPeople with dementia who had a poisoning exposure reported to the NSW PIC (Australia's largest PIC). MethodsA retrospective study was conducted using data from the NSW PIC from July 2014 to July 2019. All calls pertaining to individuals with a reported diagnosis of dementia (Alzheimer's disease or other) or who were taking an antidementia drug were included. Descriptive analysis was performed to characterize poisoning exposures, substances involved, and sources of error. ResultsA total of 2726 cases involving individuals with dementia [mean age = 79.5 (standard deviation 11.0) years; 56.2% female] were reported to the NSW PIC after intentional or unintentional poisoning. Therapeutic errors comprised 1692 (62.1%) of all reported cases followed by accidental exposures which contributed 711 (26.1%). The most common therapeutic substances responsible for therapeutic errors were donepezil (137 cases, 8.1%) and paracetamol (87 cases, 5.1%). The greatest proportion of all accidental exposures was attributed to hand sanitizer (46 cases, 6.5%). Over one-half of therapeutic errors (n = 1021, 60.3%) were linked to double dosing or mistiming of medications, and nursing home or carer errors were implicated in 385 cases (22.8%). Calls were most commonly made by family (n = 1187, 43.5%) and handled at home (n =1444, 53.0%). Conclusions and ImplicationsTherapeutic errors and accidental poisonings are of concern in people with dementia. Strategies to reduce these potentially preventable adverse events should be further explored.

True and Pseudo Cholinesterase levels in short and long-term of pesticides exposures

The present study is aimed to study and analyze the true and pseudo Cholinesterase levels in the subjects exposed to pesticides during short term by intentional or accidental intake and long term exposure due to their occupation were studied at Department of Biochemistry, SVS medical college and hospital mahbubnagar district. Whole blood cholinesterase levels and Pseudo cholinesterase levels were estimated. 150 people were taken as controls who had no medical illness and a total number of 300 cases of pesticide poisoning were selected, aged between 20 to 55 years, which consist of 150 acute poisoning and 150 chronic poisoning subjects in Mahbubnagar district, were taken as case study, the detailed case history and the type of organophosphorus pesticide taken were recorded. Mean and standard deviation (S.D) of all variables were calculated and compared with those of controls. Statistical significance was assessed and P-value &lt;0.05 were considered significant.&#x0D; During acute poisoning the mean value of Whole blood cholinesterase/True cholinesterase (U / L) in acute poisoning cases on first day was 1.267± 0.612 on 3th day was 1.651±0.647, on 7th day was 2.221±0.684 and at the end of 6 months was 3.970±0.404.The difference between the study group and control group (4.0 ± 0.39) was found to be statistically significant in1st, 3rd, 7th day but not significant at the end of 6 months. The mean value of serum cholinesterase/pseudo cholinesterase (U/L) in acute poisoning cases on first day was 2213.05 ± 1749.81, on 3th day was 2862.3 ± 2025.6, on 7th day was 4008.4 ± 2355.9 and at the end of 6 months was 7708.34 ± 880.72.The difference between the study group and control group (7991.97 ± 1276.5) was found to be statistically significant in1st, 3rd, 7th day but not significant at the end of 6 months.&#x0D; During chronic poisoning (exposure) the mean value of Whole blood cholinesterase (U/L) in controls is 4.0 ± 0.39 as compared to 3.019 ± 0.848 in cases of chronic poisoning. The difference between the study group and control group was found to be statistically significant. The mean value of serum cholinesterase/pseudo cholinesterase (U/L) in controls was 7991.97 ± 1276.5 as compared to 6214 ± 1189 in cases of chronic poisoning. The difference between the study group and control group was found to be statistically significant.